The spine is an osteochondrosis a chronic disease in which degenerative changes in the vertebrae and the vertebrae between them occur.Depending on the site of the spinal damage, it is distinguished: osteochondrosis of the cervical region, osteochondrosis of the chest region and osteochondrosis of the lumbar region.To diagnose osteochondrosis of the spine, radiography should be performed and complications (such as intervertebral disk hernia) in the case of MRI of the spine.In the treatment of osteochondrosis of the spine and, in combination with medication, it is widely used for reflexology, massage, manual therapy, physiotherapy and physiotherapy exercises.
Etiology and pathogenesis
Up to one degree of spine osteochondrosis develops in all elderly people and is a process of aging aging.Earlier or later, atrophic changes occur on the intervertral disc, but overloads of injuries, diseases and various spine contribute to the earlier occurrence of osteochondrosis.The most common osteochondrosis in the cervix and lumbar spine osteochondrosis.
The theory of about 10 osteochondrosis has been developed: vascular, hormonal, mechanical, hereditary, infectious allergic and others.But neither of them gives a complete explanation for the changes in the spine, and they are complemented by each other.
It is believed that the main point of the occurrence of osteochondrosis is the constant overload of the spinal engine, which consists of two adjacent vertebrae.Such overload can occur as a result of motor stereotype - posture, session and walking.Poster disorders, sitting in a bad pose, walking with the uneven spine, cause additional burden on the spine plates, ligaments and muscles.The process can worsen the characteristics of the spine structure and the trophy of tissue due to inadequate factors.Most often, the wicked in the structure can be found in the cervix and lead to vascular disorders and the early appearance of osteocondrosis of the cervical spine.
The occurrence of osteocondrosis of the lumbar region is more commonly related to overloading during the rise in inclination and severity.The disk between healthy vertebrae is resistant due to the hydrophilicity of the pulpon kernel in the center of the center loads.The core contains a large amount of water and the liquids, as you know, are thickened.The breakdown of a healthy vertebrae can occur with a compression of more than 500 kg, while the disk has changed as a result of osteochondrosis with 200 kg compression.In the 200 kg load, the person's spine has 70 kg when the body holds 15 kg before 200 in the body.Such pressure is due to the low size of the paste seed.As the tilt increases to 700, the load on intervertebral plates will be 489 kg.Therefore, the first clinical manifestations of osteochondrosis of the lumbar spine occur during the lifting or after weights, doing housework, weeding in the garden, etc.
The destruction of the fibrous ring of the plate, the connective tissue of the ligaments and capsules causes the reaction of the immune system and the development of aseptic inflammation by swelling of the aspect joints and the surrounding tissues.Due to the displacement of the spinal bodies, the capsules of the surface joints are stretched and the changed intervertebral disk is not secured by the bodies of the adjacent vertebrae.The instability of the spine segment develops.Due to the instability, the spinal cord is a violation of radicular syndrome.With the osteochondrosis of the cervix, this often occurs during head turns, with osteocondrosis of the lumbar region - during body decisions.It is possible to create a functional block of the spinal engine segment.The reason for this is to reduce the compensation of the muscles of the spine.
The intervertebral disk has a hernia when the disk is hindered, the rear longitudinal ligament crack and the protrusion of the plate in the spinal canal.However, if the core of the disk is displaced in the cerebrospinal channel, such a hernia is called an explosion.The severity and duration of the pain is much greater than such a hernia than the non -explosion.The disk hernia can cause radicular syndrome or compression of the spinal cord.
In the case of osteochondrosis, the growth of bone tissue occurs with the formation of osteophytes - the outgrowth of bones on the body and processes of the vertebrae.Osteophytes can also cause spinal compression or cause radicular syndrome.
Symptoms of osteochondrosis of the spine
The main symptom of osteochondrosis of the spine is pain.The pain can be acute, increases with high intensity, the smallest movement of the affected segment, and therefore places the patient into a forced position.Thus, with the cervical spine osteochondrosis, the patient holds his head in the least painful pose and cannot reverse, the chest region with osteochondrosis, the pain is still deep breathing, and the lumbar region's osteocondrosis is difficult to sit, rise and walk.Such pain syndrome is typical of compression of the spine nerve spine.
The cases are approx.80% have dull pain of constant nature and moderate intensity.In such cases, the doctor should distinguish the manifestations of the spine osteochondrosis from the myositis of the back muscles.Dull pain in osteochondrosis is due to excessive muscle tension due to a significant stretch of the affected spinal motor segment, inflammatory changes or significantly stretching the intervertebral disc.Patients with such pain are missing forced, but the restrictions of movements and physical activity are revealed.Patients with osteochondrosis of the cervical spine avoid sharp turns and tilts with their heads, with osteochondrosis of the lumbar region - sit down and get up, avoiding the body.
Complications of osteochondrosis of the spine
Complications of osteochondrosis are related to the intervertebral disk hernia.These include squeezing the spinal cord, which is numbing, the weakness of certain muscle groups of the limbs (depending on the compression level), which leads to the appearance of paresis, muscle atrophy, changes in tendon reflexes, urination and emptying.The hernia between the vertebrae can cause compression of the arteries, which nourishes the spinal cord with the formation of ischemic areas (spinal cord infarction) with the death of nerve cells.This is presented by the appearance of a nervous system deficiency (impaired movements, sensitivity, tropical disorders) that corresponds to the level and prevalence of ischemia.
Diagnosis of osteochondrosis of the spine
The diagnosis of osteochondrosis of the spine is made by a neurologist or spinal cord.In the initial stages, the radiography of the spine is performed in 2 projections.If necessary, they can make a separate spine segment and take further forecasts.To diagnose intervertebral hernia, assessment of the state of the spinal cord and osteochondrosis, magnetic and resonance tomography (spinal MRI).MRI plays an important role in differential diagnosis of osteochondrosis and other spinal disorders: tuberculosis spondilitis, osteomyelitis, tumors, anching spondel, rheumatism, infectious injuries.Occasionally, in the case of complex osteochondrosis of the cervical spine, syringomyelia is required.In some cases, if MRI is impossible, myelography is visible.
Discography allows targeted examination of the intervertebral disk affected.Electrophysiological tests are performed to determine the degree and localization of nerve pathways to monitor the process of restoration during treatment.
Treatment of osteochondrosis of the spine
During the acute period, peace is shown in the affected spinal engine segment.To this end, with osteochondrosis of the cervix, the fixation with Chantz collar, the lumbar region osteochondrosis - the bed rest.Fixing is also required for osteocondrosis of the cervical region with the instability of the spine segment.
Non -steroid anti -inflammatory drugs (NSAIDs) are used in osteochondrosis: diclofenac, nimesulide, lornoxicam, meloxicam.With intense pain syndrome, for example, painkillers are presented by the central effect of fluortin analgesic.Muscle relaxants are used to relieve muscle tension - tolperisone, thizanidine.In some cases, it is advisable to prescribe anticonvulsant drugs - carbamazepine, gabapentin;Antidepressants, including inhibitors of reverse capture of serotonin (cerseralin, paroxetin).
In the case of radicular syndrome, inpatient treatment is indicated.It is possible that the local introduction of glucocorticoids, the treatment of edema, and the use of adhesion.It is widely used in the treatment of osteochondrosis, physiotherapy, reflexology, massage, and physiotherapy.The use of manual therapy requires a clear adherence to its implementation technique and with special caution in the treatment of osteochondrosis of the cervix.
Spinal operations are primarily indicated by a significant compression of the spinal cord.This consists of removing the intervertebral disk hernia and decompression of the spinal canal.It is possible to have microdisectomy, laser reconstruction of the disc, replace the affected disk with an implant, stabilization of the spine segment.